Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Knipe H, Skandhan A, et al. Preterm premature rupture of membranes. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-12125
Preterm premature rupture of membranes (PPROM) refers to rupture of membranes prior to 37 weeks of gestation.
It is thought to occur in 0.4-2% of all pregnancies. It however may account for up to one-third of all preterm births (particularly in the United States 5).
PPROM will cause a leak of amniotic fluid with resultant reduction in amniotic volumes.
Etiology
Risk factors include:
Antenatal ultrasound
While there are studies confirming no increased of intrauterine infection with usage of transvaginal scanning 7, some recommended transperineal ultrasound instead as a precautionary measure 6.
Treatment and prognosis
Treatment is often conservative with management options dependent on development of complications. There are some occasional reports of reported "resealing" of the leak with reaccumulation of fluid and normal outcomes. A PPROM in early pregnancy (<20 weeks gestation) generally carries a poor prognosis.
Complications
The likelihood of complications is often dependent upon the timing of membrane rupture, the amount of residual amniotic fluid and length of time of persistent oligohydramnios
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fetal
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maternal
- main maternal risk is infection
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1. Kaakaji Y, Nghiem HV, Nodell C et-al. Sonography of obstetric and gynecologic emergencies: Part I, Obstetric emergencies. AJR Am J Roentgenol. 2000;174 (3): 641-9. AJR Am J Roentgenol (full text) - Pubmed citation
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2. Levine D, Goldstein RB, Callen PW et-al. The effect of oligohydramnios on detection of fetal anomalies with sonography. AJR Am J Roentgenol. 1997;168 (6): 1609-11. AJR Am J Roentgenol (abstract) - Pubmed citation
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3. Goodwin TM, Montoro MN, Muderspach L et-al. Management of Common Problems in Obstetrics and Gynecology. Wiley-Blackwell. (2010) ISBN:1405169168. Read it at Google Books - Find it at Amazon
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3. Borna S, Borna H, Khazardoost S et-al. 'Perinatal outcome in preterm premature rupture of membranes with Amniotic fluid index < 5 (AFI < 5). BMC Pregnancy Childbirth. 2004;4 (1): 15. doi:10.1186/1471-2393-4-15 - Free text at pubmed - Pubmed citation
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5. Simhan HN, Canavan TP. Preterm premature rupture of membranes: diagnosis, evaluation and management strategies. BJOG. 2005;112 Suppl 1 : 32-7. doi:10.1111/j.1471-0528.2005.00582.x - Pubmed citation
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6. Bluth EI. Ultrasound, a practical approach to clinical problems. Thieme Publishing Group. (2008) ISBN:3131168323. Read it at Google Books - Find it at Amazon
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7. Carlan SJ, Richmond LB, O'brien WF. Randomized trial of endovaginal ultrasound in preterm premature rupture of membranes. Obstet Gynecol. 1997;89 (3): 458-61. doi:10.1016/S0029-7844(97)00002-1 - Pubmed citation
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8. Devlieger R, Millar LK, Bryant-greenwood G et-al. Fetal membrane healing after spontaneous and iatrogenic membrane rupture: a review of current evidence. Am. J. Obstet. Gynecol. 2006;195 (6): 1512-20. doi:10.1016/j.ajog.2006.01.074 - Free text at pubmed - Pubmed citation
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9. Vergani P, Ghidini A, Locatelli A et-al. Risk factors for pulmonary hypoplasia in second-trimester premature rupture of membranes. Am. J. Obstet. Gynecol. 1994;170 (5 Pt 1): 1359-64. - Pubmed citation
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10. Kilbride HW, Yeast J, Thibeault DW. Defining limits of survival: lethal pulmonary hypoplasia after midtrimester premature rupture of membranes. Am. J. Obstet. Gynecol. 1996;175 (3 Pt 1): 675-81. Am. J. Obstet. Gynecol. (link) - Pubmed citation
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